温经汤加减治疗卵巢早衰临床研究

Clinical Study on Modified Channel-Warming Decoction in the Treatment of Premature Ovarian Failure

目的:观察温经汤加减治疗卵巢早衰的临床疗效。方法:将2022年12月至2023年12月就诊于河南中医药大学第一附属医院的86例卵巢早衰患者按照随机数字表法分为对照组和观察组,每组各43例。对照组给雌孕激素序贯疗法,观察组给予温经汤加减。比较两组患者的临床疗效及治疗前后性激素水平[卵泡刺激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_(2))、促黄体生成素(luteinizing hormone,LH)]、卵巢动脉血流动力学参数(卵巢动脉收缩期峰值流速、搏动指数和阻力指数)、卵巢储备功能[卵巢最大平面平均直径、窦卵泡数抗苗勒管激素(nti-mullerian hormone,AMH)]变化情况。结果:观察组有效率为76.74%,对照组有效率为65.11%,差异具有统计学意义(P<0.05)。两组患者治疗后E_(2)高于本组治疗前,FSH、LH低于本组治疗前,差异具有统计学意义(P<0.05),两组患者治疗后E_(2)、FSH、LH比较,差异无统计学意义(P>0.05)。两组患者治疗后卵巢动脉收缩期峰值流速高于本组治疗前,巢动脉搏动指数、阻力指数低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组治疗后卵巢最大平面平均直径、窦卵泡数及AMH高于本组治疗前,差异具有统计学意义(P<0.05);两组治疗后卵巢最大平面平均直径、窦卵泡数及AMH比较,差异无统计学意义(P>0.05)。结论:温经汤加减治疗卵巢早衰疗效确切,可改善患者激素水平、卵巢动脉血流动力学参数及卵巢储备功能。

Objective:To observe the clinical efficacy of Modified Channel-Warming Decoction on premature ovarian failure.Methods:A total of 86 patients with premature ovarian failure who visited The First Affiliated Hospital of Henan University of CM from December 2022 to December 2023 were randomly divided into the control group and the observation group,with 43 cases in each group.The control group received sequential estrogen-progesterone therapy,while the observation group received Modified Channel-Warming Decoction.The clinical efficacy,the changes in hormone levels [including follicle-stimulating hormone(FSH),estradiol(E_2),luteinizing hormone(LH)],ovarian artery hemodynamic parameters(such as peak systolic velocity of the ovarian artery,pulsatility index,and resistance index),and ovarian reserve function [including mean diameter of the largest ovarian plane,antral follicle count,anti-mullerian hormone(AMH)] before and after treatment were compared between the two groups.Results:The effective rate of the observation group was 76.74%,significantly higher than 65.11% of the control group(P<0.05).After treatment,E_(2) levels in both groups were higher than those before treatment,while FSH and LH levels were lower than those before treatment,with statistically significant differences(P<0.05).There were no statistically significant differences in E_2,FSH,and LH levels between the two groups(P>0.05);The peak systolic velocity of the ovarian artery was higher,and the pulsatility index and resistance index were lower in both groups compared to those before treatment,with statistically significant differences(P<0.05);The mean diameter of the largest ovarian plane,antral follicle count,and AMH levels were higher in both groups compared to those before treatment,with statistically significant differences(P<0.05);There were no statistically significant differences in these parameters between the two groups(P>0.05).Conclusion:Modified Channel-Warming Decoction has a definite clinical efficacy on premature ovarian failure.It can improve hormone levels,ovarian artery hemodynamic parameters,and ovarian reserve function in patients.